In this project, entitled, "Integrative immersive approaches to cultural competence," we will develop an integrated curriculum in cultural competence for medical students, residents, community physicians, and medical teachers. The curriculum is driven by our conceptual understanding of provider-based factors that influence health disparities, and by learning theories of special relevance to cultural competence. The project will be led by Clarence H. Braddock III, MD, MPH, Associate Professor of Medicine. Dr. Braddock has extensive experience with curriculum development, implementation, and evaluation. Dr. Braddock also has a strong track record in racial/ethnic disparities and patient-physician communication. The project builds on an internal collaboration between Dr. Braddock and the Stanford Center of Excellence, an HRSA-funded program to promote cultural competence across the curriculum. The project has three phases: In Phase 1, we will develop and pilot test the curricular modules. The modules will incorporate teachjing strategies that build on learning theories of reflective practice, social cognitive theory, and experiential learning theory. For example, learners will practice communication skills with standardized patients (SP), using our long-standing SP program. During Phase 2, we will implement and evaluate the final modules among several target learner populations. Finally, in Phase 3, we shall disseminate our curriculum, including faculty development for medical teachers at other institutions. Our clinical focus is cardiovascular prevention with Latino and African-American patients with obesity, hypertension, and Type II diabetes mellitus. We also plan to develop, implement and evaluate a curriculum for medical teachers, building on the success of the Stanford Faculty Development Center, which uses a train-the-trainer approach to content and teaching methods to lisseminate curricula nationally.